Neuroimaging and neurocircuitry in post-traumatic stress disorder: What is currently known?
- Kaloyan Tanev MD
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Neurobiologic, psychologic, and social factors interact jointly to create and perpetuate the symptoms of posttraumatic stress disorder (PTSD). The fear conditioning paradigm in animal research helped researchers gather preclinical evidence for the possible contribution of several brain areas to PTSD symptoms. In the past 10 years, highly sophisticated neuroimaging techniques made it possible for researchers to look at the brain of patients with PTSD and draw conclusions about the neurocircuitry underlying PTSD symptoms. In this article, the author will review the evidence from neuroimaging studies for the involvement of the following brain areas in PTSD neurocircuitry: the amygdala, the anterior cingulate cortex and subcallosal gyrus, the inferior frontal gyrus, the posterior cingulate cortex, and the hippocampus. Neuroimaging studies have shown these areas as altered in structure or function in patients with PTSD. The author also presents the normal functions that these areas subserve and, whenever possible based on the evidence, infer how their dysfunction may contribute importantly to the symptomatology of PTSD.
- LeDoux JE: Emotion circuits in the brain. Ann Rev Neurosci 2000, 23:155–184. Written by one of the researchers most intimately involved with outlining the neurocircuitry of conditioned fear in animals, this article gives an excellent overview of the fear conditioning paradigm, its underlying neuroanatomy and neurophysiology, and how the fear conditioning model can inform us about cognition and emotions in people. CrossRef
- LeDoux JE: Emotional memory systems in the brain. Behav Brain Res 1993, 58:69–79. CrossRef
- LeDoux JE: Emotional memory: in search of systems and synapses. Ann NY Acad Sci 1993, 702:149–157. CrossRef
- Ono T, Nishijo H: Neurophysiological basis of emotion in primates: neuronal responses in the monkey amygdala and anterior cingulated cortex. In The New Cognitive Neurosciences. Edited by Gazzaniga M. Cambridge: MIT Press; 2000:1099–1114.
- Van der Kolk B: The body keeps the score. In Traumatic Stress. Edited by Van der Kolk B, McFarlane AC, Weisaeth L. New York: Guilford Press; 1996:214–241.
- Bremner JD, Vythilingam M, Vermetten E, et al.: MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder. Am J Psychiatry 2003, 160:924–932. CrossRef
- Bremner JD, Vythilingam M, Vermetten E, et al.: Neural correlates of declarative memory for emotionally valenced words in women with posttraumatic stress disorder related to early childhood sexual abuse. Biol Psychiatry 2003, 53:879–889. CrossRef
- Bremner JD, Staib LH, Kaloupek D, et al.: Neural Correlates of exposure to traumatic pictures and sound in Vietnam combat veterans with and without posttraumatic stress disorder: a positron emission tomography study. Biol Psychiatry 1999, 45:806–816. CrossRef
- Bremner JD, Narayan M, Staib LH, et al.: Neural correlates of memories of childhood sexual abuse in women with and without posttraumatic stress disorder. Am J Psychiatry 1999, 156:1787–1795.
- Bremner JD, Innis RB, Ng CK, et al.: PET measurement of central metabolic correlates of yohimbine administration in posttraumatic stress disorder. Arch Gen Psychiatry 1997, 54:246–256.
- De Bellis MD, Keshavan MS, Shufflett H, et al.: Brain structures in pediatric maltreatment-related posttraumatic stress disorder: a sociodemographically matched study. Biol Psychiatry 2002, 52:1066–1078. CrossRef
- De Bellis MD, Hall J, Boring AM, et al.: A pilot longitudinal study of hippocampal volumes in pediatric maltreatmentrelated posttraumatic stress disorder. Biol Psychiatry 2001, 50:305–309. CrossRef
- De Bellis MD, Keshavan MS, Spencer S, et al.: N-acetylaspartate concentration in the anterior cingulated of maltreated children and adolescents with PTSD. Am J Psychiatry 2000, 157:1175–1177. CrossRef
- Fennema-Notestine C, Stein MB, Kennedy CM, et al.: Brain morphometry in female victims of intimate partner violence with and without posttraumatic stress disorder. Biol Psychiatry 2002, 1:1089–1101. CrossRef
- Gurvits TV, Shenton ME, Hokama H, et al.: Magnetic resonance imaging study of hippocampal volume in chronic, combatrelated posttraumatic stress disorder. Biol Psychiatry 1996, 40:1091–1099. CrossRef
- Lanius RA, Williamson PC, Hopper J, et al.: Recall of emotional states in posttraumatic stress disorder: and fMRI investigation. Biol Psychiatry 2003, 53:204–210. CrossRef
- Lanius RA, Williamson PC, Boksman K, et al.: Brain activation during script-driven imagery induced dissociative responses in PTSD: a functional magnetic resonance imaging investigation. Biol Psychiatry 2002, 52:305–311. CrossRef
- Lanius RA, Williamson PC: Neural correlates of traumatic memories in posttraumatic stress disorder: a functional MRI investigation. Am J Psychiatry 2001, 158:1920–1922. CrossRef
- Liberzon I, Taylor SF, Amdur R, et al.: Brain activation in PTSD in response to trauma-related stimuli. Biol Psychiatry 1999, 45:817–826. CrossRef
- Osuch EA, Benson B, Geraci M, et al.: Regional cerebral blood flow correlated with flashback intensity in patients with posttraumatic stress disorder. Biol Psychiatry 2001, 50:246–253. CrossRef
- Pissiota A, Frans O, Fernandez M, et al.: Neurofunctional correlates of posttraumatic stress disorder: a PET symptom provocation study. Eur Arch Psychiatry Clin Neurosci 2002, 252:68–75. CrossRef
- Rauch SL, Shin LM, Segal E, et al.: Selectively reduced regional cortical volumes in post-traumatic stress disorder. Neuroreport 2003, 14:913–916. CrossRef
- Rauch SL, Whalen PJ, Shin LM, et al.: Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study. Biol Psychiatry 2000, 47:769–776. CrossRef
- Rauch S, van der Kolk B: A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-drive imagery. Arch Gen Psychiatry 1996, 53:380–387.
- Shin LM, Whalen PJ, Pitman RK, et al.: An fMRI study of anterior cingulate function in posttraumatic stress disorder. Biol Psychiatry 2001, 50:932–942. CrossRef
- Shin LH, McNally RJ, Kosslyn SM, et al.: Regional cerebral blood flow during script-driven imagery in childhood sexual abuse-related PTSD: a PET investigation. Am J Psychiatry 1999, 156:575–584.
- Shin LM, Kosslyn SM, McNally RJ, et al.: Visual imagery and perception in posttraumatic stress disorder: a positron emission tomographic investigation. Arch Gen Psychiatry 1997, 54:233–237.
- Noback CR, Strominger NL, Demarest RJ: The Human Nervous System. Philadelphia: Williams & Wilkins; 1996.
- Morgan MA, LeDoux JE: Differential contribution of dorsal and ventral medial prefrontal cortex to the acquisition and extinction of conditioned fear in rats. Behav Neurosci 1995, 109:681–688. CrossRef
- Morgan MA, Romanski LM, LeDoux JE: Extinction of emotional learning: contribution of medial prefrontal cortex. Neurosci Letters 1993, 163:109–113. CrossRef
- Vogt BA, Finch DM, Olson CR: Functional heterogeneity in cingulate cortex: the anterior executive and posterior evaluative regions. Cereb Cortex 1992, 2:435–443.
- Hobson JA, Pace-Schott EF, Stickgold R: Consciousness: its vicissitudes in waking and sleep. In The New Cognitive Neurosciences. Edited by Gazzaniga M. Cambridge: MIT Press; 2000:1341–1354.
- Pardo JV, Pardo PJ, Janer KW, Raichle ME: The anterior cingulated cortex mediates processing selection in the Stroop attentional conflict paradigm. Proc Natl Acad Sci U S A 1990, 87:256–259. CrossRef
- McNally RJ, Kaspi SP, Riemann BC, Zeitlin SB: Selective processing of threat cues in posttraumatic stress disorder. J Abnorm Psychol 1990, 99:398–402. CrossRef
- Bremner JD: Neuroimaging studies in post-traumatic stress disorder. Curr Psychiatry Rep 2002, 4:254–263. An excellent recent review of the neuroimaging literature in PTSD. Based on the available data, the article advances important hypotheses about the neurocircuitry of PTSD. CrossRef
- Bremner JD, Randall P, Scott TM, et al.: MRI-Based measurement of hippocampal volume in patients with combatrelated posttraumatic stress disorder. Am J Psychiatry 1995, 152:973–981.
- Bremner JD, Randall PR, Scott TM, et al.: Deficits in short-term memory in adult survivors of childhood abuse. Psych Res 1995, 59:97–107. CrossRef
- Bremner JD, Scott TM, Delaney RC, et al.: Deficits in shortterm memory in posttraumatic stress disorder. Am J Psychiatry 1993, 150:1015–1019.
- Bremner JD, Randall P: MRI-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse: a preliminary report. Biol Psychiatry 1997, 41:23–32. CrossRef
- Bonne O, Brandes D: Longitudinal MRI study of hippocampal volume in trauma survivors with PTSD. Am J Psychiatry 2001, 158:1248–1251. CrossRef
- De Bellis MD, Keshavan MS, Clark DB, et al.: AE Bennett Research Award: developmental traumatology, part II: brain development. Biol Psychiatry 1999, 45:1271–1284. CrossRef
- Gilbertson MW, Shenton ME, Ciszewski A, et al.: Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma. Nat Neurosci 2002, 5:1242–1247. This is the first study to attempt to answer the question of the temporal relationship between hippocampal structural changes in patients with PTSD and their trauma or PTSD symptoms. The study uses an elegant design of comparing two sets of twins, which permits researchers to draw conclusions about the interaction of “nature” versus “nurture.” CrossRef
- Schuff N, Neylan TC, Lenoci MA, et al.: Decreased hippocampal N-acetylaspartate in the absence of atrophy in posttraumatic stress disorder. Biol Psychiatry 2001, 50:952–959. CrossRef
- Schuff N, Marmar CR, Weiss DS, et al.: Reduced hippocampal volume and n-acetyl aspartate in posttraumatic stress disorder. Ann NY Acad Sci 1997, 821:516–520. CrossRef
- Semple WE, Goyer P, McCormick R, et al.: Preliminary report: brain blood flow using PET in patients with posttraumatic stress disorder and substance-abuse histories. Biol Psychiatry 1993, 34:115–118. CrossRef
- Stein MB, Koverrola C, Hanna C, et al.: Hippocampal volume in women victimized by childhood sexual abuse. Psychol Med 1997, 27:1–9. CrossRef
- Villareal G, Hamilton DA: Reduced hippocampal volume and total white matter volume in posttraumatic stress disorder. Biol Psychiatry 2002, 52:119–125. CrossRef
- Villareal G, King CY: Brain imaging in posttraumatic stress disorder. Semin Clin Neuropsychiatry 2001, 6:131–145. Another excellent review of neuroimaging and PTSD. The article succinctly describes neuroimaging techniques, and organizes the review of functional imaging studies based on their study paradigms. CrossRef
- Sapolsky RM: Why stress is bad for your brain. Science 1996, 273:749–750. CrossRef
- Starkman MN, Gebarksi SS, Berent S, Schteigart DE: Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing’s syndrome. Biol Psychiatry 1992, 32:756–765. CrossRef
- Yehuda R: Are glucocortoids responsible for putative hippocampal damage in PTSD? How and when to decide. Hippocampus 2001, 11:85–89. CrossRef
- McEwen BS: Commentary of PTSD discussion. Hippocampus 2001, 11:82–84. CrossRef
- De Bellis MD, Clark DB, Beers SR, et al.: Hippocampal volume in adolescent onset alcohol use disorders. Am J Psychiatry 2000, 157:737–744. CrossRef
- Villareal G, Petropoulos H, Hamilton DA, et al.: Proton magnetic resonance spectroscopy of the hippocampus and occipital white matter in PTSD: preliminary results. Can J Psychiatry 2002, 47:666–670.
- De Bellis MD, Matcheri SK: Superior temporal gyrus volumes in maltreated children and adolescents with PTSD. Biol Psychiatry 2002, 51:544–552. CrossRef
- Neuroimaging and neurocircuitry in post-traumatic stress disorder: What is currently known?
Current Psychiatry Reports
Volume 5, Issue 5 , pp 369-383
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- Kaloyan Tanev MD (1)
- Author Affiliations
- 1. Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, 06030, Farmington, CT, USA